? Newly diagnosed - Wet spot when giving injections

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Cheryl8

Cheryl8

Member Since 2016
Hi,
I'm hoping someone can help. Today was the third time I gave my kitty his injection. He gets Lantus, 10 units/mg (?) once/daily, and there is always a wet spot. This last time, I made sure I could see his skin and I know it went in. What am I doing wrong? I'm so worried that he isn't getting enough insulin but I can't risk giving him more and having him experience Hypoglycemia.
 
From my reply to your post in the Welcome forum:
Insulin is dosed in units. Lantus, like most other human insulin is U100 strength. That mean that there are 100 units per ml of Lantus.
What does are yo getting since " 10 units/mg (?) " does not make sense and by the ? yo seem to maybe not understand too.
What length needle are you using? Insulin syringes come in 1/2 inch (12.7 mm) length, 5/16 inch(8 mm) and the shorter 6 mm ones.
With the longer ones sometimes sometimes one goes right through the skin.
Are ou tenting the skin? That pulling up on some skin and injecting in the pinched part.
 
Hi Larry and Kitties,

Sorry, he gets 1 unit, 1 x per day. The needle is 31 gauge and 8mm 5/16" long. Yes, I am tenting the skin. It also happened when I did it the first time in front of the vet tech who taught me how to do it. She had me do it again, which after reading the info on this board, I should not have done. That explains why he had low blood sugar the first night. My vet doesn't want me to test his BG which I don't understand at all. The only way I knew he had low blood sugar is because he was woozy and had glassy eyes.
 
Cheryl8 said:
Hi Larry and Kitties,

Sorry, he gets 1 unit, 1 x per day. The needle is 31 gauge and 8mm 5/16" long. Yes, I am tenting the skin. It also happened when I did it the first time in front of the vet tech who taught me how to do it. She had me do it again, which after reading the info on this board, I should not have done. That explains why he had low blood sugar the first night. My vet doesn't want me to test his BG which I don't understand at all. The only way I knew he had low blood sugar is because he was woozy and had glassy eyes.
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why in the world would they NOT want you to test?? it's the only way to be reliably sure that his numbers are too low. My guess is you went all the way through, or hit the plunger before being fully inserted. insert it by holding the barrel of the needle, THEN put your finger on the plunger. don't have your finger on the plunger as you are inserting or you could accidently dispense the insulin too soon.
 
Cheryl8 said:
My vet doesn't want me to test his BG which I don't understand at all.
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You don't need your vet's permission or blessing to home test....You just do it...not only is it the only way to keep your kitty safe, it also helps you to understand how your cat is doing

If you live in the US, WalMart's Relion Confirm or Micro are great meters (about $15) and a box of 100 strips is $35.88. It also takes the tiniest sample size!

You'll need a box of lancets (little plastic pieces with a sharp needle-like point) to poke the ear ...Some people like using a lancet device that holds the lancet, but I think freehanding is easier since you can see where you're poking. Get lancets for "Alternate Site Testing"...usually 25 through 28 gauge .....the lancets that come with some meter packages are usually 33 gauge which are too small for new ear testing

There are lots of videos on YouTube that show how to home test....this is one I like a lot:
 
Thank you! I feel the same way. I have human friends with Diabetes and have witnessed how important it can be to know the BG level. Im going to go ahead and get the meter you mentioned. If nothing else, it will give me peace of mind when I am worried. His first night home from the hospital, I believe he had pretty low BG and if I had a meter, I could have known right away. He had a drunk walk and seemed to stare at nothing. I have hypoglycemia so I thought I recognized the symptoms. I didn't know about Karo, so I rubbed sugar water on his gums and gave him more food to eat (including some baby food which he will always eat). He seemed better and I made him walk a few times in the next couple of hours to make sure he didn't have the wobbly walk. However, since I didn't really know for sure, I was worried that I was giving him sugar water and making his blood sugar too high. FYI he also has HCM, CHF, Asthma with only one lung so other things can cause symptoms for him. With the Congestive Heart Failure, its very importune to control his diabetes to keep fluid from developing in his lungs any quicker.
 
Question, my monitor will be here Tuesday. Is there any way for me to know if my cat has high BG? He also has Congestive Heart Failure and the high BG is very bad for him?
 
Cheryl8 said:
Is there any way for me to know if my cat has high BG?
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You mean without a meter? Not really....but drinking lots of water, peeing lots and needing to eat a LOT of food are all signs of high blood glucose.

We have several other cats on this board dealing with CHF as well as diabetes....One is @Wendy&Neko, I think...maybe she'll have some words of wisdom for you
 
Hi there Cheryl and welcome. What is your kitty's name? My Neko was diagnosed in May with CHF and HCM, though a follow up echocardiogram a month later shows it was transient and her cardiomyopathy is minor now. Is your kitty taking anything for his CHF/HCM? You are right that getting the blood sugar under control will help his thirst. My Neko also has chronic kidney disease and I had to stop giving fluids because it's hard on her heart. But with her blood sugar numbers relatively decent, she's not as thirsty so she doesn't have to have Lasix to remove excess fluids.
 
Hi Wendy,
My Little boy is Teddy. He's 17 years old and was diagnosed last year with HCM and CHF. His heart is stable for now but we keep getting the fluid build up which requires tapping to remove. He has an amazing cardiologist that he sees regularly. He also has asthma and a collapsed lung. He has been a real trooper. The diabetes is rough to add to what he has. He's on Lasix, vetmedin and inhaled steroids. He was in the hospital for three days last week but home now. I've given him three Lantus injections (1/ day, 1 unit) so far and I'm not great at it. There is always some wet fur at the end and I'm concerned that he's not getting his full dose of insulin. He's acting a little odd today. He usually sticks with me like glue but today he's sitting more to himself. Any pointers or input you have would be greatly appreciated.
 
How are you doing the injections? You can either tent the skin and put the needle into the bottom parallel to the body or instead of tenting you can pick up the skin and roll it away from you, exposing the skin and then shoot at an angle down from thet. You want to make sure you are shooting where there is plenty of loose skin. Here is a diagram of good shooting locations.
injsitesforcats1.jpg


As far as the heart, other FD heart kitties here are @Woodsywife and @Doodles & Karen . A good cardiologist really helps. Neko is on Vetmedin and I find it doesn't affect her blood sugar. The inhaled steroids are likely raising Teddy's blood sugar, and Lasix may too.

Have you thought about trying to home test Teddy. I really does help to keep him safe. Kitties are often stressed at the vet clinic, so blood sugar readings there may not be accurate. Home testing is really the only way to know if he's getting too much or too little insulin.
 
Thank you. It is so helpful to have a different method. The tenting thing is not that intuitive for me.

I just tested Teddys BG (after numerous tries I did it). His blood sugar is 446. I know that's high so I called the Vet to see if I should give him more insulin or bring him in. They said as long as he's eating, drinking and going to the bathroom that's OK to wait it out and do not give any more insulin (Lantus). If he seems to decline then I should bring him in.

We gave him his Lantus injection at 6:45 AM and its around 11 AM. Does it take a while to bring the blood sugar down?

He's appetite is not great today but he did eat some and he has been going to the bathroom and I think drinking although its not excessive. Is there anything else I can do for him to help him?
 
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We give Lantus twice a day, 12 hours apart, the same dose each time. It usually takes around 2-3 hours for the Lantus to start to take effect and the peak fo the insulin action is somewhere around 4-7 hours after the injection. Different cats react differently and their low point (nadir) varies. You'll see the phrase ECID (each cat is different) and it's very true. So if you tested at your 11AM that is 4 1/4 hours after the shot. We have people from around the world here, and we all have different shooting schedules, so we talk in terms of numbers of hours since the shot. Your test would be at +4.25. Did you test Teddy before you gave insulin? It would be good to know if his numbers were going up or going down at +4.25 (11AM). Most of us use a spreadsheet here to keep track of the blood sugar tests. We find it also helps us find patterns and use it to figure out how to change the dose. If you are interested, here are instructions on how to make the spreadsheet. You'll see ost of us have a link to our spreadsheets in our signature line.
 
Cheryl. Hi. My 18+ kitty was diagnosed in March with pancreatitis and possible HCM and or CHF. In June he had the echo done and confirmed HCM, enlarged heart and he had a heart attack some where in the previous 5 months. Asthma.

He was put on combo of spironolactone, benazepril, vetmedin (generic), lasix, aspirin for his heart. I was told the lantus could work better or be ineffective because of the lasix. I found no difference. However I did find that giving the lasix right after his Lantus seems to create better numbers during the day. I let a cardiologist determines Smokey's heart meds, not the regular vet.

I only use albuterol inhaler when he starts coughing. My vet is against the steroid inhaler unless it's an only option. Because it will cause elevated glucose.

Now I am going to be blunt here. Please don't hold it against me.

2 things that pop out at me, is that you are giving only one injection a day. You vet might not realize for cats if should be twice a day. He might be thinking the human way of using it.

So your kitty is having 12+ hours of rising numbers AND the bounces from it, if that one injection is lowering it so much. Plus the steroid of the inhaler. And the fluid building up. Your kitty is being hit from all angles. And probably feeling pretty bad.

Fluid and heart are the main concerns. Maybe increase of diuretics or change of meds. I don't know how long you've been giving the meds. Maybe a little more time on them is necessary.

Then the Lantus needs to be done twice a day (just like people), probably at a lower dose. You need to be home testing in order to know when a dose is safe or to much.

Talk to your vet. Be the voice for your kitty (nicely of course) Once you are home testing, if you give Lantus at lower dose twice a day the vet doesn't need to know until you tell him. A lot of vets have no clue as to treating feline diabetes. We find out the hard way, sometimes when it's to late. I don't think there is ANY insulin out there (except the new ones, not for animals yet) that is only given once a day.

Talk to your vet.
 
I gave him the blood test around 10AM. I tried to do the test before the insulin but I'm very nervous about it and Teddy did not go for it. His poor ear is red from me trying. I tried a couple of times after the injection and finally got it. I guess my test would be +3.25. The last time I know his blood sugar was Thursday morning (at the vet) and it was around 300. Should I try and test again in a little while?

I will try the spreadsheet. Thank you!
 
Hi Woodseywfe.

Thank you for the bluntness. I appreciate it. Teddy started getting insulin from the vet last Monday evening when he was diagnosed (8/8). I picked him up on Thursday and started giving him the Lantis at the vets office under the care of a vet tech (she seemed new). One thing, I have figured out is that when the tech showed me how to give the shot, he had wet fur so she had me give it to him again. He had low blood sugar that night - drunk walk and spacey. I have since learned that you never re-administer. I put sugar water/paste on his gums and he ate a fair amount of food. I had him walk a few more times that night and he seemed much better.

So since then, I gave him the shot once/day so only 3 times so far.

His new vet is actually an internist at a very advanced hospital. We go there since they have the best doctors/facility and equipment. His actual internist vet only comes in two days a week to this facility. Having said all of that, it doesn't mean that she knows much about diabetes. I'll call her and see if I can switch to 2/day. I am absolutely going to home test. I cannot imagine not knowing his numbers. He is going back in for a curve test on Tuesday and he will be there from 8AM to 8PM. I don't want to wait until then to switch him to 2/day. I feel that every day with high BG numbers its increasing the fluid in his heart.

All of his heart care/meds is by a cardiologist at the same facility. He is great. They consult him for anything to do with Teddy's heart issues. :)
So grateful to him, he has kept Teddy alive these past months.
 
Cheryl8 said:
I gave him the blood test around 10AM. I tried to do the test before the insulin but I'm very nervous about it and Teddy did not go for it. His poor ear is red from me trying. I tried a couple of times after the injection and finally got it. I guess my test would be +3.25. The last time I know his blood sugar was Thursday morning (at the vet) and it was around 300. Should I try and test again in a little while?

I will try the spreadsheet. Thank you!
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You can test as often as you want. After you test you can squeeze the ear with a cotton pad for a few seconds, and I will occastionally apply a little Neosporin ointment.
 
Teddy will pick up on your stress. Try a few deep breaths before testing. In between tests use triple antibiotic OINTMENT with pain relief, not the creme.

Try a test 6 hours after you gave insulin. Don't forget to give him a treat after. By the way what food are you feeding him?
 
I'm feeding him Purina Proplan Veterinary Diets, DM Dietetic Management. We just switch to it Thursday. Before that, he ate Hill Duck dd pretty much his whole life. I can tell he feels pretty crappy. He's not himself.

I'll test again at the 6 hour mark. that will be 12:45. Now that I have the first one under my belt, I'm hoping it is easier on us both.
 
Cheryl8 said:
Hi Woodseywfe.

Thank you for the bluntness. I appreciate it. Teddy started getting insulin from the vet last Monday evening when he was diagnosed (8/8). I picked him up on Thursday and started giving him the Lantis at the vets office under the care of a vet tech (she seemed new). One thing, I have figured out is that when the tech showed me how to give the shot, he had wet fur so she had me give it to him again. He had low blood sugar that night - drunk walk and spacey. I have since learned that you never re-administer. I put sugar water/paste on his gums and he ate a fair amount of food. I had him walk a few more times that night and he seemed much better.

So since then, I gave him the shot once/day so only 3 times so far.

His new vet is actually an internist at a very advanced hospital. We go there since they have the best doctors/facility and equipment. His actual internist vet only comes in two days a week to this facility. Having said all of that, it doesn't mean that she knows much about diabetes. I'll call her and see if I can switch to 2/day. I am absolutely going to home test. I cannot imagine not knowing his numbers. He is going back in for a curve test on Tuesday and he will be there from 8AM to 8PM. I don't want to wait until then to switch him to 2/day. I feel that every day with high BG numbers its increasing the fluid in his heart.

All of his heart care/meds is by a cardiologist at the same facility. He is great. They consult him for anything to do with Teddy's heart issues. :)
So grateful to him, he has kept Teddy alive these past months.
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OMG. She gave another shot immediately???? Just so you know. Never ever give a second one if you think the first didn't go in. And stop the tech if they ever want to do that again. That definitely would have caused his symptoms. He had a double dose, it could have turned extremely critical. I would mention that to the doctor. The tech needs more training. It wasn't that twice a day was to much. It was that dose 4u given once was to much.

Glad to hear you have a cardiologist for him. And your making progress with home testing. Again sorry if I was to blunt. It just irks me to no end what some vets do.
 
Cheryl8 said:
I'm feeding him Purina Proplan Veterinary Diets, DM Dietetic Management. We just switch to it Thursday. Before that, he ate Hill Duck dd pretty much his whole life. I can tell he feels pretty crappy. He's not himself.

I'll test again at the 6 hour mark. that will be 12:45. Now that I have the first one under my belt, I'm hoping it is easier on us both.
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It does get easier. The reason for the six hour test is that is when Lantus hits the lowest reading in glucose for most cats but not all. Lantus is based on how low the glucose will get.

Once you get proficient at testing, you can do curves at home. Being at a vet can raise glucose a significant amount so it would not be to accurate.

Is the food dry food? If so it is very high in carbs which will also cause the glucose to be high. But until you are proficient in testing do NOT stop it. It can drop him real quick into unsafe territory. The wet DM pate style is okay to give. Get the testing and fluid controlled first. The rest can be done as it gets better.
 
Thank you. Yes, I read that many times now on all the sites. It is truly shocking to me now that I know. As soon as I read that, I knew what had happened.
So do you think the 2 unit dose could be making his sugar high now?

Blunt is good. I feel that when it comes to our fur babies, there is no sense in beating around the bush.

FYI - I just looked at the vet instructions they gave me and I can see that originally the doctor had said 1/2 unit every 24 hours. There is a 2nd newer page that says 1 unit every 24 hours.

He doesn't eat dry food -hasn't for a number of years.
 
One more thing. Think of the 2 times (12 hrs apart) that are convenient for testing and giving insulin. I test, shoot and feed at 7 & 7. Some do 6/6 or 8/8 etc. depending on work schedules and such. Then you can start testing at those times and get both you and Teddy use to a routine. There will be other times but for now those are the most critical ones. You want to know it's safe to give insulin and then one test before you go to bed so you know Teddy is safe for the night.

Actually if you only gave one shot this morning, you can give it tomorrow at your preferred time that you will stick to and get the routine going.
 
Without the testing its hard to know why it's high. After that second shot Teddy went dangerously low and his body released sugars. Since he isn't use to numbers that low, of course it caused a spike in sugar. We call that bouncing. Much like humans, you eat a candy bar and it spikes your sugar.

Also some of his meds especially inhaler can cause a rise. Once you get testing data, we can figure out if it's a bounce or meds.

Would you be comfortable starting 2 injections tomorrow 12 hrs apart? The one unit might be okay, it was that double dose the tech did as to how they are instructing you.

We can tag people here for the dose formula.
 
I just tested his BG again and it is now 417. He hasn't eaten since this morning and he didn't eat his normal amount. He also just tried to jump on the couch and didn't make it. His back legs are pretty shaky. Should I take him in to the vet?

So you think the same dose, 1 unit but twice a day instead of 1 unit 1 a day?

Teddy just asked for food and he is chowing down. He also is looking me in the eye again, which is more normal. He must have heard me mention the V.E. T.
 
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Let's tag some people. 1u once a day definitely isn't enough.

The legs could be neuropathy due to the high glucose. It will get better as level gets better. You can order Zobaline online for that. It's a vitamin b. It works great. Let's what others suggest for dosing.

@Chris & China , @Bobbie And Bubba , @Wendy&Neko

Can anyone help with dose advise here. The vet has her on once a day Lantus because of a misinformed tech who gave insulin twice which looks like caused a hypo. So now the vet thinks once a day is okay.

Cheryl has been reading things here and wants to start every 12 hrs. I don't know what to advise for dose as there are other medical concerns. And she just started home testing today. So not quite up to speed.
 
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Cheryl8 said:
I just tested his BG again and it is now 417. He hasn't eaten since this morning and he didn't eat his normal amount. He also just tried to jump on the couch and didn't make it. His back legs are pretty shaky. Should I take him in to the vet?

So you think the same dose, 1 unit but twice a day instead of 1 unit 1 a day?

Teddy just asked for food and he is chowing down. He also is looking me in the eye again, which is more normal. He must have heard me mention the V.E. T.
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Do you have any idea how the 1u worked, not counting the time it was given twice? Teddy probably feels very crappy. Poor thing.

How much does he weigh?
 
He hasn't been himself since we came home that day. Having him ask for food just now is more normal. He feels crappy for sure. I can't really tell how he did because I only started testing him today.
 
Where are you located? If you can hold on till we hear from others that would be good. If you can given insulin @9 pm or even 10 pm as long as it's 12 hrs or more from last dose and you can give again in 12 hrs we can get feed back. I'm thinking the original dose the vet told you 1/2 unit but every 12 hrs. As long as you think you can get a few tests in.
 
I'm in Los Angeles. Yes. I will hold on. Its very stressful for him to go to the vet so neither of us want to go. 12 hours from his last dose will be 6:45PM PST.
 
So that 417 reading was 6 hrs after shot?

I'm here just making pickles so it might be a few minutes for me to answer
 
Yes. 446 at around 10AM and 417 - 6 hours later. He ate and went back to sleep. I
can always call his vet and tell them what I am going to do. His doctor didn't even want me to test. If I hadn't, I wouldn't know how high he is.
They don't know about his low blood sugar on Thursday.
 
Hi Cheryl just read through the thread. So at 6:45 PST you shot 1 unit, is that correct? And you have only been shooting 1 unit once a day?
 
Yes, that is correct. 6:45 AM PST. One unit injected per day of Lantus.

One note: I have had some wet fur these days so I'm also assuming he didn't get the full dose. How much less I don't know...I think I was pulling out the needle to quickly. Today, I counted to 10 before pulling it out.
 
I am thinking also that 1 unit twice a day would be a good starting place. Lantus is always RX twice a day so the depot can build. The wet fur does sound like you didn't get all the insulin. Someone above suggested holding the syringe by the barrel until you place the needle into the tented skin then put your thumb on the plunger. That will help. But, fur shots happen to the best of us experienced shooters too. I am going to link my favorite video for injection technique that I found online after having a series of fur shots in a row. :banghead: But as others have said, never give another injection after the fur shot as you have no idea how much insulin actually got in.

If 6:45 AM and PM PST is a good time for you to shoot then I would give him 1 unit tonight at that time. Try and get a test at +2 ( 2 hours after the injection, we talk in + numbers as we are all world in this forum)which will tell you how active the cycle could be. And as Woodseywife said, tell the vet that his tech had you give a second shot; she clearly needs more training AND they should have been training you with saline solution and NOT insulin.

We are here to help so keep asking questions. @Woodsywife , I am making pickles today too! LOL
 
Thank you! I 'm going to let my vet know what happened and what I want to do (2 x per day). I'll let you know what happens next.
 
Thanks Bobbie. I'll go to my own thread about the pickles as to not clog here.

@Cheryl8 so you okay for awhile? Test at 6:30 post reading here, if high give 1 unit and feed. All within 15 minutes t/s/f. You will see this a lot.

Are you computer literate? The spreadsheet is a very important tool we need to help you. It is done in Google sheets not excel. If you have trouble are some who can do it for you. Just ask.
 
Cheryl8 said:
Thank you! I 'm going to let my vet know what happened and what I want to do (2 x per day). I'll let you know what happens next.
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I definitely would let the vet know about the tech. I didn't want to say anything earlier, but that could have been deadly for Teddy. Sadly to say it has happened.
 
Cheryl8 said:
Thank you so much! yes, I' m ok for awhile. your help has been priceless.
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I'm still around tonight. Monday and Tuesday I will be off line.

Don't be shy asking for help. Teddy needs to be safe. In the space where you put the title there is a drop down arrow to the left. Pick the ? People look for those and the 911 so help is faster.
 
Do you know how much Teddy weighs? Is he overweight, underweight or is that about ideal?

I agree that 1 unit may be a good starting point

It would be great if you'd go ahead and get your signature box filled out too....that way we don't have to keep asking the same questions over and over again.

Go to your sign in name at the top and click on "Signature" (there should be a drop down menu)
A new box will pop up for you to add some details so people don't have to keep asking you the same questions over and over again

Things like:
Your name/cats name, age, sex, date of diagnosis, type of insulin, type of meter, type of food, any other health issues??

If you need help with your spreadsheet, feel free to send me a private message....it only takes about 30 seconds to set up so it's no big deal. You'll need a Google account but that's all.
 
Welcome, sorry you and Teddy are here but it truly is the best place to be for feline diabetes. You've gotten great advise and glad you're getting a meter. I didn't home test or barely did for more months than I'd like to admit before finding FDMB. Since you're using Lantus it would be great to move your thread over to the Lantus & Levemir group. We call it L&LL (lantus and levemir land) Here is the link. http://www.felinediabetes.com/FDMB/forums/lantus-glargine-levemir-detemir.9/ Stay with this thread for today but tomorrow it would be helpful for you to post there.

Doodles has severe HCM and CHF taking 30mg Lasik twice a day and Enalapril. He also has a condition called IAA (insulin auto-antibodies) which makes it very difficult for me to control his diabetes. If you need help setting up the spreadsheet let us know...there are people to help you. It's the most important tool for treating Teddy with Lantus.

Ask as many questions as you'd like. Also take a look at the 2 protocols we use. Since Teddy in eating only wet food Tight Regulation Tight Regulation (TR)
has the best chance for remission or some prefer Start Low Go Slow SLGS . Both require home testing.

I'll leave you with that for now. :bighug::bighug:
 
Hi Chris,
Teddy is 8.5 to 9 lbs. He has never been overweight. Thank you, I will fill in that area.
 
Teddy stopped eating everything. Also, he won't take his lasix or vetmedin. I will have to dissolve it into a syringe and squirt it down. Do I sill do the insulin? Even though he won't eat?
 
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